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Arthritis, osteomyelitis, septicemia and meningitis caused by Klebsiella in a low-birth-weight newborn: a case report.

Ghorashi Z, Nezami N, Hoseinpour-Feizi H, Ghorashi S, Tabrizi JS - J Med Case Rep (2011)

Bottom Line: A low-birth-weight, 33-day-old Caucasian girl with respiratory distress syndrome was admitted to our hospital.She was therefore treated with ciprofloxacin and co-trimoxazole for eight weeks.After completion of the treatment course, she completely improved with excellent weight gain and without any adverse effects during three years of follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Drug Applied Research Center, Tabriz University (Medical Sciences), Tabriz, Iran. Dr.nezami@gmail.com.

ABSTRACT

Introduction: Klebsiella pneumoniae is in most cases a hospital-acquired infection and presents as pneumonia, septicemia and meningitis in patients with some predisposing factors, including prematurity, intravenous catheter, history of antibiotic therapy and intravenous nutrients.

Case presentation: A low-birth-weight, 33-day-old Caucasian girl with respiratory distress syndrome was admitted to our hospital. She developed septicemia, meningitis, polyarticular arthritis and osteomyelitis by nosocomial K. pneumoniae which was resistant to most antibiotics except ciprofloxacin. She was therefore treated with ciprofloxacin and co-trimoxazole for eight weeks. After completion of the treatment course, she completely improved with excellent weight gain and without any adverse effects during three years of follow-up.

Conclusion: In the resistant strain of K. pneumoniae, ciprofloxacin could be considered as a therapeutic option with the prospect of a good outcome, even in neonates and infants.

No MeSH data available.


Related in: MedlinePlus

Chest X-ray obtained at the time of admission. Bilateral osteomyelitis in the humerus presented as osteolysis and involucrum. Also, there is sequestration because of osteonecrosis and a pathologic fracture in the proximal part of the humerus. Dislocation of right glenohumeral joint brings up the arthritis diagnosis. There is complete osteolysis in proximal metaphysis in the left humerus and arthritis in the left glenohumeral joint. The heart, lung and pleural space have a normal appearance, while the thymus is atrophic.
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Figure 1: Chest X-ray obtained at the time of admission. Bilateral osteomyelitis in the humerus presented as osteolysis and involucrum. Also, there is sequestration because of osteonecrosis and a pathologic fracture in the proximal part of the humerus. Dislocation of right glenohumeral joint brings up the arthritis diagnosis. There is complete osteolysis in proximal metaphysis in the left humerus and arthritis in the left glenohumeral joint. The heart, lung and pleural space have a normal appearance, while the thymus is atrophic.

Mentions: Her cerebrospinal fluid (CSF) was purulent, and CSF analysis showed 520 mg/dL protein; 16 mg/dL glucose; many white blood cells (WBCs), with 85% polymorphonuclear cells and 15% lymphocytes; and 25 red blood cells (RBCs)/mm3. The results of the other laboratory tests are shown in Table 1. In the CSF and blood culture, K. pneumonia was resistant to most of the antibiotics and sensitive only to ciprofloxacin and co-trimoxazole. Her chest X-ray showed bilateral humeral osteomyelitis and bilateral glenohumeral joint arthritis (Figure 1).


Arthritis, osteomyelitis, septicemia and meningitis caused by Klebsiella in a low-birth-weight newborn: a case report.

Ghorashi Z, Nezami N, Hoseinpour-Feizi H, Ghorashi S, Tabrizi JS - J Med Case Rep (2011)

Chest X-ray obtained at the time of admission. Bilateral osteomyelitis in the humerus presented as osteolysis and involucrum. Also, there is sequestration because of osteonecrosis and a pathologic fracture in the proximal part of the humerus. Dislocation of right glenohumeral joint brings up the arthritis diagnosis. There is complete osteolysis in proximal metaphysis in the left humerus and arthritis in the left glenohumeral joint. The heart, lung and pleural space have a normal appearance, while the thymus is atrophic.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3141700&req=5

Figure 1: Chest X-ray obtained at the time of admission. Bilateral osteomyelitis in the humerus presented as osteolysis and involucrum. Also, there is sequestration because of osteonecrosis and a pathologic fracture in the proximal part of the humerus. Dislocation of right glenohumeral joint brings up the arthritis diagnosis. There is complete osteolysis in proximal metaphysis in the left humerus and arthritis in the left glenohumeral joint. The heart, lung and pleural space have a normal appearance, while the thymus is atrophic.
Mentions: Her cerebrospinal fluid (CSF) was purulent, and CSF analysis showed 520 mg/dL protein; 16 mg/dL glucose; many white blood cells (WBCs), with 85% polymorphonuclear cells and 15% lymphocytes; and 25 red blood cells (RBCs)/mm3. The results of the other laboratory tests are shown in Table 1. In the CSF and blood culture, K. pneumonia was resistant to most of the antibiotics and sensitive only to ciprofloxacin and co-trimoxazole. Her chest X-ray showed bilateral humeral osteomyelitis and bilateral glenohumeral joint arthritis (Figure 1).

Bottom Line: A low-birth-weight, 33-day-old Caucasian girl with respiratory distress syndrome was admitted to our hospital.She was therefore treated with ciprofloxacin and co-trimoxazole for eight weeks.After completion of the treatment course, she completely improved with excellent weight gain and without any adverse effects during three years of follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Drug Applied Research Center, Tabriz University (Medical Sciences), Tabriz, Iran. Dr.nezami@gmail.com.

ABSTRACT

Introduction: Klebsiella pneumoniae is in most cases a hospital-acquired infection and presents as pneumonia, septicemia and meningitis in patients with some predisposing factors, including prematurity, intravenous catheter, history of antibiotic therapy and intravenous nutrients.

Case presentation: A low-birth-weight, 33-day-old Caucasian girl with respiratory distress syndrome was admitted to our hospital. She developed septicemia, meningitis, polyarticular arthritis and osteomyelitis by nosocomial K. pneumoniae which was resistant to most antibiotics except ciprofloxacin. She was therefore treated with ciprofloxacin and co-trimoxazole for eight weeks. After completion of the treatment course, she completely improved with excellent weight gain and without any adverse effects during three years of follow-up.

Conclusion: In the resistant strain of K. pneumoniae, ciprofloxacin could be considered as a therapeutic option with the prospect of a good outcome, even in neonates and infants.

No MeSH data available.


Related in: MedlinePlus